Clinical activity of the γ-secretase inhibitor PF-03084014 in adults with desmoid tumors (aggressive fibromatosis)

Shivaani Kummar, Geraldine O.Sullivan Coyne, Khanh T. Do, Baris Turkbey, Paul S. Meltzer, Eric Polley, Peter L. Choyke, Robert Meehan, Rasa Vilimas, Yvonne Horneffer, Lamin Juwara, Ann Lih, Amul Choudhary, Sandra A. Mitchell, Lee J. Helman, James H. Doroshow, Alice P. Chen

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Purpose: Desmoid tumors (aggressive fibromatosis) arise from connective tissue cells or fibroblasts. In general, they are slow growing and do not metastasize; however, locally aggressive desmoid tumors can cause severe morbidity and loss of function. Disease recurrence after surgery and/or radiation and diagnosis of multifocal desmoid tumors highlight the need to develop effective systemic treatments for this disease. In this study, we evaluate objective response rate after therapy with the g-secretase inhibitor PF-03084014 in patients with recurrent, refractory, progressive desmoid tumors. Patients and Methods: Seventeen patients with desmoid tumors received PF-03084014 150 mg orally twice a day in 3-week cycles. Response to treatment was evaluated at cycle 1 and every six cycles, that is, 18 weeks, by RECIST (Response Evaluation Criteria in Solid Tumors) version 1.1. Patient-reported outcomes were measured at baseline and at every restaging visit by using the MD Anderson Symptoms Inventory. Archival tumor and blood samples were genotyped for somatic and germline mutations in APC and CTNNB1. Results: Of 17 patients accrued to the study, 15 had mutations in APC or CTNNB1 genes. Sixteen patients (94%) were evaluable for response; five (29%) experienced a confirmed partial response and have been on study for more than 2 years. Another five patients with prolonged stable disease as their best response remain on study. Patient-reported outcomes confirmed clinician reporting that the investigational agent was well tolerated and, in subgroup analyses, participants who demonstrated partial response also experienced clinically meaningful and statistically significant improvements in symptom burden. Conclusion: PF-03084014 was well tolerated and demonstrated promising clinical benefit in patients with refractory, progressive desmoid tumors who receive long-term treatment.

Original languageEnglish (US)
Pages (from-to)1561-1569
Number of pages9
JournalJournal of Clinical Oncology
Volume35
Issue number14
DOIs
StatePublished - May 10 2017
Externally publishedYes

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Aggressive Fibromatosis
Amyloid Precursor Protein Secretases
Neoplasms
Connective Tissue Cells
Germ-Line Mutation
Therapeutics
2-(5,7-difluoro-1,2,3,4-tetrahydronaphthalen-3-ylamino)-N-(1-(2-methyl-1-(neopentylamino)propan-2-yl)-1H-imidazol-4-yl)pentanamide
Fibroblasts
Radiation
Morbidity
Recurrence
Equipment and Supplies
Mutation

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Clinical activity of the γ-secretase inhibitor PF-03084014 in adults with desmoid tumors (aggressive fibromatosis). / Kummar, Shivaani; Coyne, Geraldine O.Sullivan; Do, Khanh T.; Turkbey, Baris; Meltzer, Paul S.; Polley, Eric; Choyke, Peter L.; Meehan, Robert; Vilimas, Rasa; Horneffer, Yvonne; Juwara, Lamin; Lih, Ann; Choudhary, Amul; Mitchell, Sandra A.; Helman, Lee J.; Doroshow, James H.; Chen, Alice P.

In: Journal of Clinical Oncology, Vol. 35, No. 14, 10.05.2017, p. 1561-1569.

Research output: Contribution to journalArticle

Kummar, S, Coyne, GOS, Do, KT, Turkbey, B, Meltzer, PS, Polley, E, Choyke, PL, Meehan, R, Vilimas, R, Horneffer, Y, Juwara, L, Lih, A, Choudhary, A, Mitchell, SA, Helman, LJ, Doroshow, JH & Chen, AP 2017, 'Clinical activity of the γ-secretase inhibitor PF-03084014 in adults with desmoid tumors (aggressive fibromatosis)', Journal of Clinical Oncology, vol. 35, no. 14, pp. 1561-1569. https://doi.org/10.1200/JCO.2016.71.1994
Kummar, Shivaani ; Coyne, Geraldine O.Sullivan ; Do, Khanh T. ; Turkbey, Baris ; Meltzer, Paul S. ; Polley, Eric ; Choyke, Peter L. ; Meehan, Robert ; Vilimas, Rasa ; Horneffer, Yvonne ; Juwara, Lamin ; Lih, Ann ; Choudhary, Amul ; Mitchell, Sandra A. ; Helman, Lee J. ; Doroshow, James H. ; Chen, Alice P. / Clinical activity of the γ-secretase inhibitor PF-03084014 in adults with desmoid tumors (aggressive fibromatosis). In: Journal of Clinical Oncology. 2017 ; Vol. 35, No. 14. pp. 1561-1569.
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T1 - Clinical activity of the γ-secretase inhibitor PF-03084014 in adults with desmoid tumors (aggressive fibromatosis)

AU - Kummar, Shivaani

AU - Coyne, Geraldine O.Sullivan

AU - Do, Khanh T.

AU - Turkbey, Baris

AU - Meltzer, Paul S.

AU - Polley, Eric

AU - Choyke, Peter L.

AU - Meehan, Robert

AU - Vilimas, Rasa

AU - Horneffer, Yvonne

AU - Juwara, Lamin

AU - Lih, Ann

AU - Choudhary, Amul

AU - Mitchell, Sandra A.

AU - Helman, Lee J.

AU - Doroshow, James H.

AU - Chen, Alice P.

PY - 2017/5/10

Y1 - 2017/5/10

N2 - Purpose: Desmoid tumors (aggressive fibromatosis) arise from connective tissue cells or fibroblasts. In general, they are slow growing and do not metastasize; however, locally aggressive desmoid tumors can cause severe morbidity and loss of function. Disease recurrence after surgery and/or radiation and diagnosis of multifocal desmoid tumors highlight the need to develop effective systemic treatments for this disease. In this study, we evaluate objective response rate after therapy with the g-secretase inhibitor PF-03084014 in patients with recurrent, refractory, progressive desmoid tumors. Patients and Methods: Seventeen patients with desmoid tumors received PF-03084014 150 mg orally twice a day in 3-week cycles. Response to treatment was evaluated at cycle 1 and every six cycles, that is, 18 weeks, by RECIST (Response Evaluation Criteria in Solid Tumors) version 1.1. Patient-reported outcomes were measured at baseline and at every restaging visit by using the MD Anderson Symptoms Inventory. Archival tumor and blood samples were genotyped for somatic and germline mutations in APC and CTNNB1. Results: Of 17 patients accrued to the study, 15 had mutations in APC or CTNNB1 genes. Sixteen patients (94%) were evaluable for response; five (29%) experienced a confirmed partial response and have been on study for more than 2 years. Another five patients with prolonged stable disease as their best response remain on study. Patient-reported outcomes confirmed clinician reporting that the investigational agent was well tolerated and, in subgroup analyses, participants who demonstrated partial response also experienced clinically meaningful and statistically significant improvements in symptom burden. Conclusion: PF-03084014 was well tolerated and demonstrated promising clinical benefit in patients with refractory, progressive desmoid tumors who receive long-term treatment.

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